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Samarakoon U, Wolfson AR, Zhou L, Bassir F, Phillips E, Kroshinsky D, Cucka B, Biglione B, Phadke NA, Jaggers J, Byrne EC, Judd AD, Blumenthal KG. Understanding the Patient Experience of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A Qualitative Study. J Am Acad Dermatol 2024:S0190-9622(24)00653-4. [PMID: 38677336 DOI: 10.1016/j.jaad.2024.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/07/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Upeka Samarakoon
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Anna R Wolfson
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Harvard Medical School, Boston, MA, USA
| | - Li Zhou
- Harvard Medical School, Boston, MA, USA,; Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Fatima Bassir
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Elizabeth Phillips
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA,; Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Neelam A Phadke
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Harvard Medical School, Boston, MA, USA
| | - Jordon Jaggers
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Emily C Byrne
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Allen D Judd
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Kimberly G Blumenthal
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA,; Harvard Medical School, Boston, MA, USA,.
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Biglione B, Cucka B, Iriarte C, Locascio JJ, Goldfarb JW, Gutium A, Lima XT, Kroshinsky D. A retrospective review of outcomes after hyperbaric oxygen therapy for the treatment of calciphylaxis. J Am Acad Dermatol 2024; 90:45-51. [PMID: 37586460 DOI: 10.1016/j.jaad.2023.07.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/13/2023] [Accepted: 07/02/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Calciphylaxis is a thrombotic vasculopathy characterized by painful necrotic ulcerations. There are no Food and Drug Administration approved therapies despite high mortality. OBJECTIVE To compare mortality and wound healing outcomes in patients treated with hyperbaric oxygen therapy (HBOT) in addition to intravenous sodium thiosulfate (IV STS) versus patients who received IV STS only. Findings were stratified by dialysis status and modality. METHODS 93 patients were included, with 57 patients in the control group (IV STS) and 36 patients in the treatment group (HBOT + IV STS). Mortality data were analyzed with traditional survival analyses and Cox proportional hazard models. Longitudinal wound outcomes were analyzed with mixed effects modeling. RESULTS Univariate survival analyses showed that full HBOT treatment was associated with significantly (P = .016) longer survival time. Increasing number of HBOT sessions was associated with improved mortality outcomes, with 1, 5, 10 and 20 sessions yielding decreasing hazard ratios. There was also a significant (P = .042) positive association between increasing number of HBOT sessions and increased wound score. LIMITATIONS Data collection was retrospective. CONCLUSION HBOT may have a role in the treatment of calciphylaxis with benefits demonstrated in both mortality and wound healing. Larger prospective studies are needed to identify which patients would most benefit from this intervention.
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Affiliation(s)
- Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Christopher Iriarte
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Joseph J Locascio
- Harvard Medical School, Boston, Massachusetts; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeremy W Goldfarb
- Harvard Medical School, Boston, Massachusetts; Department of Anesthesia, Massachusetts Eye and Ear Infirmary, Boston Massachusetts
| | - Adina Gutium
- Department of Internal Medicine, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Xinaida T Lima
- Clinical Unit for Research Trials and Outcomes in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Federal University of Ceará, Fortaleza, Brazil
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Cucka B, Biglione B, Xia J, Tan AJ, Chand S, Rrapi R, El Saleeby C, Kroshinsky D. Complicated Cellulitis is an Independent Predictor for Increased Length of Stay in the Neonatal Intensive Care Unit. J Pediatr 2023; 262:113581. [PMID: 37353147 DOI: 10.1016/j.jpeds.2023.113581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/23/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To assess cellulitis in the neonatal intensive care unit (NICU) setting and identify risk factors for its disease severity and whether cellulitis influences length of stay (LOS). STUDY DESIGN In this retrospective study, patients with cellulitis were identified using the electronic health record while admitted to the NICU at Massachusetts General for Children from January 2007 to December 2020. Demographic and clinical data were extracted from patient records. Two multivariable logistic regression models were constructed to assess for independent predictors for increased LOS (≥30 days) and complicated cellulitis in the hospital. RESULTS Eighty-four patients met the study criteria; 46.4% were older than 14 days at the time of diagnosis of cellulitis, 61.9% were non-White, and 83.3% were born prematurely; 48.8% had complicated cellulitis as defined by overlying hardware (41.7%), sepsis (7.1%), requirement for broadened antibiotic coverage (7.1%), bacteremia (4.8%), and/or abscess (3.6%). The mean hospital LOS was 58.5 ± 36.1 days SD, with 72.6% having a LOS greater than 30 days. Independent predictors of increased LOS were extreme prematurity (<28 weeks' gestation) (OR: 14.7, P = .03), non-White race (OR: 5.7, P = .03), and complicated cellulitis (OR: 6.4, P = .03). No significant predictors of complicated cellulitis were identified. CONCLUSIONS This study identifies complicated cellulitis in the NICU as an independent predictor of increased hospital LOS in neonates. Implementation of strategies to mitigate the development of cellulitis may decrease LOS among this high-risk population.
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Affiliation(s)
- Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Joyce Xia
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Alice J Tan
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Chadi El Saleeby
- Divisions of Hospital Medicine and Infectious Disease, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA; Harvard Medical School, Boston, MA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
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Tan AJ, Xia J, Herringshaw E, Mayur O, Iqbal A, Cucka B, Biglione B, Locascio JJ, Kroshinsky D. Gender disparities in isotretinoin prescribing patterns for pediatric patients before and during practice changes introduced by the COVID-19 pandemic. Pediatr Dermatol 2023; 40:869-872. [PMID: 37495565 DOI: 10.1111/pde.15394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/24/2023] [Indexed: 07/28/2023]
Abstract
Isotretinoin is a systemic therapy approved for acne and has historically required lab monitoring in addition to adherence to the iPLEDGE Risk Evaluation and Mitigation Strategy (REMS) given the medication's teratogenic effects. The COVID-19 pandemic resulted in the expansion of telemedicine, acceptance of remote pregnancy tests, and relaxation of lab monitoring practices. A retrospective review of 142 pediatric patients was conducted, and multivariate linear regression was performed to examine differences in prescribing patterns pre-COVID and during COVID. Backward elimination identified gender and the interaction between acne severity and number of systemic treatments tried before isotretinoin as significant factors associated with increased number of visits to isotretinoin initiation, with females requiring more visits before starting isotretinoin at every acne severity level and even after accounting for systemic treatments previously tried. While the changes catalyzed by the pandemic may have improved visit-related burdens for patients and caregivers, female patients with acne continue to be delayed in receiving isotretinoin even when adjusting for acne severity and systemic treatments trialed, underscoring persistent gender disparities in prescribing practices for isotretinoin.
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Affiliation(s)
- Alice J Tan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joyce Xia
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emilee Herringshaw
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Omkar Mayur
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Arshia Iqbal
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joseph J Locascio
- Harvard Catalyst Biostatistics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Xia J, Tan AJ, Biglione B, Cucka B, Ko L, Nguyen ED, Khoury CC, Robinson MK, Nigwekar SU, Kroshinsky D. Nephrogenic Calciphylaxis Arising after Bariatric Surgery: A Case Series. Am J Nephrol 2023; 55:196-201. [PMID: 37487472 DOI: 10.1159/000531784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023]
Abstract
Nephrogenic calciphylaxis is associated with multiple risk factors including long-term dialysis dependence, hyperphosphatemia, hypercalcemia, parathyroid hormone derangements, vitamin K deficiency, obesity, diabetes mellitus, warfarin use, and female sex. Bariatric surgery is known to cause altered absorption, leading to mineral and hormonal abnormalities in addition to nutritional deficiency. Prior case reports on calciphylaxis development following bariatric surgery have been published, though are limited in number. We report a case series of five bariatric patients from a single institution who developed nephrogenic calciphylaxis between 2012 and 2018. These patients had a history of bariatric surgery, and at the time of calciphylaxis diagnosis, demonstrated laboratory abnormalities associated with surgery including hypercalcemia (n = 3), hyperparathyroidism (n = 2), hypoalbuminemia (n = 5), and vitamin D deficiency (n = 5), in addition to other medication exposures such as vitamin D supplementation (n = 2), calcium supplementation (n = 4), warfarin (n = 2), and intravenous iron (n = 1). Despite the multifactorial etiology of calciphylaxis and the many risk factors present in the subjects of this case series, we submit that bariatric surgery represents an additional potential risk factor for calciphylaxis directly stemming from the adverse impact of malabsorption and overuse of therapeutic supplementation. We draw attention to this phenomenon to encourage early consideration of calciphylaxis in the differential for painful skin lesions arising after bariatric surgery as swift intervention is essential for these high-risk patients.
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Affiliation(s)
- Joyce Xia
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA,
| | - Alice J Tan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lauren Ko
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Emily D Nguyen
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Charbel C Khoury
- Department of Nephrology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Malcolm K Robinson
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sagar U Nigwekar
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Biglione B, Zhong C, Iriarte C, Cucka B, Hoang MP, Kroshinsky D. Cutaneous Leukocytoclastic Vasculitis as the Presenting Sign of Systemic Lupus Erythematosus. Am J Med 2023; 136:368-371. [PMID: 36502957 DOI: 10.1016/j.amjmed.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Mass
| | - Connie Zhong
- Department of Dermatology, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Christopher Iriarte
- Department of Dermatology, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Mass
| | - Mai P Hoang
- Harvard Medical School, Boston, Mass; Department of Pathology, Massachusetts General Hospital; Boston, Mass
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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Cucka B, Biglione B, Lima XT, Smith GP, Yun BJ, Kroshinsky D. Post-discharge follow-up attendance after pediatric dermatology consultation in the emergency department: A retrospective analysis. Pediatr Dermatol 2022; 39:937-939. [PMID: 36263442 DOI: 10.1111/pde.15152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Abstract
The emergency department (ED) is a frequent source of care for pediatric patients with dermatologic conditions, possibly owing to limited access to routine and urgent outpatient dermatology appointments. The demographics, clinical characteristics, follow-up scheduling practices, and attendance rates of 50 pediatric and 142 adult patients evaluated by the dermatology consult service in the ED were reviewed. High rates of follow-up attendance were observed in the pediatric and adult populations, with the majority receiving an appointment within 2 weeks. The dermatology consult service may play an important role in facilitating post-discharge access to outpatient care.
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Affiliation(s)
- Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Xinaida T Lima
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Dermatology, Federal University of Ceará, Fortaleza, Brazil
| | - Gideon P Smith
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian J Yun
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Cucka B, Biglione B, Zhou L, Phillips EJ, Bassir F, Samarakoon U, Rrapi R, Chand S, Wang L, Alvarez-Arango S, Blumenthal KG, Kroshinsky D. Drug reaction with eosinophilia and systemic symptoms in patients hospitalized with COVID-19: a case series from a large US healthcare system. Br J Dermatol 2022; 187:619-622. [PMID: 35700153 PMCID: PMC9350236 DOI: 10.1111/bjd.21706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/03/2022] [Accepted: 06/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Li Zhou
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elizabeth J Phillips
- Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fatima Bassir
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Upeka Samarakoon
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Liqin Wang
- Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Santiago Alvarez-Arango
- Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kimberly G Blumenthal
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
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Cucka B, Biglione B, Ko L, Nguyen ED, Khoury CC, Nigwekar SU, Robinson MK, Kroshinsky D. Calciphylaxis arising following bariatric surgery: A case series. JAAD Case Rep 2022; 28:4-7. [PMID: 36090194 PMCID: PMC9450058 DOI: 10.1016/j.jdcr.2022.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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10
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Cucka B, Grant-Kels JM. Ethical implications of the high cost of medical student visiting dermatology rotations. Clin Dermatol 2022; 40:539-540. [PMID: 35654361 DOI: 10.1016/j.clindermatol.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Bethany Cucka
- University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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Biglione B, Cucka B, Shi C, Kroshinsky D. Jaundice and morbilliform eruption in a 20-year-old female. JAAD Case Rep 2022; 31:46-48. [PMID: 36505032 PMCID: PMC9731974 DOI: 10.1016/j.jdcr.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
| | | | | | - Daniela Kroshinsky
- Correspondence to: Daniela Kroshinsky, MD, MPH, Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, 2nd Floor, Boston, MA 02114.
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12
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Biglione B, Cucka B, Kroshinsky D. Cellulitis and Its Mimickers: an Approach to Diagnosis and Management. Curr Derm Rep 2022. [DOI: 10.1007/s13671-022-00363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Biglione B, Cucka B, Chand S, Rrapi R, Gabel C, Song S, Kroshinsky D. 221 Distinguishing clinical features for pseudocellulitis in pediatric inpatients: A retrospective study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Cucka B, Biglione B, Locascio J, Goldfarb J, Gutium A, Kroshinsky D. 219 A retrospective chart review of outcomes after hyperbaric oxygen therapy for the treatment of calciphylaxis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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Cucka B, Biglione B, Chand S, Rrapi R, Gabel C, Song S, Kroshinsky D. 361 Utilization of resources for cellulitis in hospitalized patients: Predictors of cutaneous abscess diagnosed on ultrasound. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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16
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Biglione B, Cucka B, Chand S, Smith G, Yun B, Kroshinsky D. 363 Analysis of dermatology consultation follow-up after emergency department evaluation: An assessment of disparities and potential interventions to increase post-discharge care among vulnerable populations. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Biglione B, Cucka B, Chand S, Rrapi R, Gabel CK, Song S, Kroshinsky D. Distinguishing clinical features for pseudocellulitis in pediatric inpatients: A retrospective study. Pediatr Dermatol 2022; 39:570-573. [PMID: 35713395 DOI: 10.1111/pde.15014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
The clinical features of 588 pediatric inpatients admitted with a diagnosis of cellulitis were reviewed with attention to diagnostic accuracy of true cellulitis (95.1%) versus pseudocellulitis (4.9%) and utilization of specialist consultations (28.1% infectious disease, 6.1% dermatology). Laboratory abnormalities were unable to distinguish cellulitis from pseudocellulitis, supporting previous studies that routine laboratory evaluation may be unnecessary for this diagnosis. Higher rates of pseudocellulitis were identified in cases involving specialist consultation by both dermatology (44.8% pseudocellulitis, 4.1% true cellulitis, p < .001) and infectious disease (48.3% pseudocellulitis, 27.0% true cellulitis, p = .01). Thus, consultation may improve the diagnostic accuracy of suspected cellulitis among pediatric inpatients.
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Affiliation(s)
- Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sidharth Chand
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Renajd Rrapi
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Colleen K Gabel
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah Song
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Cucka B, Biglione B, Chand S, Rrapi R, Gabel CK, Song S, Kroshinsky D. Utilization of resources for cellulitis in hospitalized patients: predictors of cutaneous abscess diagnosed on ultrasound. J Eur Acad Dermatol Venereol 2022; 36:e889-e891. [PMID: 35691015 DOI: 10.1111/jdv.18321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- B Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - B Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - S Chand
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - R Rrapi
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - C K Gabel
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - S Song
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - D Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
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Cucka B, Chen SX, Biglione B, Kroshinsky D. Spotting the Target: Clinical clues in the diagnosis of disseminated Lyme disease in pregnancy. Am J Obstet Gynecol 2022; 227:526-527. [PMID: 35314134 DOI: 10.1016/j.ajog.2022.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Bethany Cucka
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Stella X Chen
- Department of Dermatology, Massachusetts General Hospital, Boston, MA; Harvard Combined Dermatology Residency Program, Harvard University, Boston, MA
| | - Bianca Biglione
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
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20
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Cucka B, Waldman RA. Letter in reply: Understanding pregnancy risk and contraception options for transmasculine individuals on gender-affirming testosterone therapy. J Am Acad Dermatol 2021; 85:e175-e176. [PMID: 33848605 DOI: 10.1016/j.jaad.2021.03.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Bethany Cucka
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Reid A Waldman
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
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